'More not necessarily best' - Researchers explore immunotherapy treatment for advanced skin cancer

The UK DANTE trial, led by Sheffield Teaching Hospitals NHS Foundation Trust and the Universities of Sheffield and Leeds, evaluated the best length of time to treat inoperable late-stage melanoma with immunotherapy.

Professor Sarah Danson, Honorary Consultant in Medical Oncology at Sheffield Teaching Hospitals, was chief Investigator of the trial. She says: “Reducing the amount of treatment is one of the hardest things to do because patients and clinical teams worry that ‘more is best’. However, more treatment may mean more side-effects, which can be a burden to patients. Through this trial, we have gained a wealth of information and important evidence on the way advanced melanoma is treated.”

The five-year trial saw 166 patients whose disease had not progressed upon reaching 12 months of treatment randomly assigned to either stop immunotherapy or continue for a further 12 months. Results revealed that 80.2 per cent of patients who discontinued immunotherapy continued to maintain disease control after a further 12 months, compared to 87.6 per cent of patients who had taken the drugs for two years or more.

Immunotherapy treatments have transformed the outlook for patients with inoperable late-stage disease – as it was considered untreatable just ten years ago. The current standard treatment is to use immunotherapy drugs for at least two years, or for as long as the drugs continue to help.

Jackie, who lives in Gainsborough, was diagnosed with inoperable stage 3 melanoma in 2018 after noticing swelling and lack of strength in her right arm. Once she had been on immunotherapy treatment for a year, she was asked if she wanted to join the DANTE trial.

“Immunotherapy had only been around seven years before I was diagnosed with advanced skin cancer, and I truly believe that if you are on the receiving end of something so fantastic – the people, the nurses and the huge team that surround you – you need to give back,” the 77-year-old says. "It was all about the people that had gone before me on the research trials.”

Since having the treatment Jackie’s tumour has shrunk to about half its size. She's also seen a slow reduction in her swelling although she still wears a compression sleeve to help with the discomfort. “I know the tumour is there but don’t often think about it. I’ve only had 50 per cent of the standard treatment but I’m glad I am as bolshy as I am as there’s so much to be gained from research...It’s so important as it will help the next cohort of people who unfortunately will have cancer like me.”